DESCRIPTION: This proposal represents the first step in establishing the foundation for a long-term programmatic study of pain beliefs. Using a randomized treatment design, the proposed study compares a cognitive- behavioral intervention with standard medical care in determining whether pain beliefs are amenable to change through standard treatments for chronic pain. This study also examines the impact of changing pain beliefs on short and long-term measures of pain, functioning, adherence, and health care use. The study also explores how individual beliefs about pain are held within the context of the larger belief system of the individual. The study will expand on pilot studies that suggest belief system complexity plays a buffering role on concurrent measures of physical and psychological distress associated with chronic conditions. Using the same randomized treatment design, this study assesses whether cognitive complexity can be increased with standard treatments for chronic pain so as to help actual pain patients realize the buffering benefits reported in analog studies. There are three specific aims to this proposal. The first aim is to evaluate whether maladaptive pain beliefs can be altered by two standard forms of pain management. The second aim is to evaluate whether belief system complexity can be increased through the two pain management strategies mentioned above. This study will assess belief system complexity prior to and following either the cognitive- behavioral pain management intervention or the standard medical control group. The third aim is to analyze the association of changes in pain beliefs and changes in belief system complexity with improvements in pain and functional status both short term (3 weeks) and long term (12 months).